临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2014年
9期
76-79
,共4页
杨淑静%宗杰%冯欢欢%孔令杰%孟庆义
楊淑靜%宗傑%馮歡歡%孔令傑%孟慶義
양숙정%종걸%풍환환%공령걸%맹경의
中毒%洗胃%胃破裂%食管%破裂%猝死
中毒%洗胃%胃破裂%食管%破裂%猝死
중독%세위%위파렬%식관%파렬%졸사
Poisoning%Gastric lavage%Stomach rupture%Esophagus%Rupture%Death,sudden
目的:探讨洗胃术致胃食管损伤的临床特点并分析发生原因。方法结合相关文献对4例洗胃术致胃食管损伤的临床资料进行回顾性分析。结果本组均因急性中毒行洗胃术,术中发生急性胃穿孔3例,食管损伤1例。行胃穿孔修补术后痊愈1例;死亡3例,于术中猝死1例,术后1h死于消化道出血1例,继发腹膜炎行剖腹探查胃穿孔修补术后死于脓毒症1例。结论患者配合插胃管、防止恶心呕吐、轻柔操作和改善洗胃机设计是减少洗胃严重并发症的关键。
目的:探討洗胃術緻胃食管損傷的臨床特點併分析髮生原因。方法結閤相關文獻對4例洗胃術緻胃食管損傷的臨床資料進行迴顧性分析。結果本組均因急性中毒行洗胃術,術中髮生急性胃穿孔3例,食管損傷1例。行胃穿孔脩補術後痊愈1例;死亡3例,于術中猝死1例,術後1h死于消化道齣血1例,繼髮腹膜炎行剖腹探查胃穿孔脩補術後死于膿毒癥1例。結論患者配閤插胃管、防止噁心嘔吐、輕柔操作和改善洗胃機設計是減少洗胃嚴重併髮癥的關鍵。
목적:탐토세위술치위식관손상적림상특점병분석발생원인。방법결합상관문헌대4례세위술치위식관손상적림상자료진행회고성분석。결과본조균인급성중독행세위술,술중발생급성위천공3례,식관손상1례。행위천공수보술후전유1례;사망3례,우술중졸사1례,술후1h사우소화도출혈1례,계발복막염행부복탐사위천공수보술후사우농독증1례。결론환자배합삽위관、방지악심구토、경유조작화개선세위궤설계시감소세위엄중병발증적관건。
Objective To investigate the clinical characteristics of gastric lavage induced gastric esophageal injury and analyze its causes. Methods Based on a literature review, the clinical data of four patients with gastric lavage induced gastric esophageal injury was retrospectively analyzed. Results Four patients with gastric lavage in this group were due to the acute poisoning. Among them, three patients suffered acute gastric perforation and one suffered esophageal injury in the period of gastric lavage performing. One patient was fully recovery after the repair operation, and the other three patients died. A-mong the three died patients, one died suddenly during the operation, one died of gastrointestinal hemorrhage 1 h after the op-eration, and the other patient died of sepsis after the repair of gastric perforation in exploratory laparotomy for secondary perito-nitis. Conclusion Patients' coordination, preventing nausea and vomiting and gentle operation in gastric tube insertion and improving gastric lavage machine design may be the keys to reduce the complications of gastric lavage.